Frazzled by Learning, Astounded by Knowledge

With all the studying I have been doing lately, I have rarely taken even a moment to appreciate how much I already know. Instead, I have (as usual) become slightly overwhelmed at how much I do not know. 

Tonight, as I was sifting through my overloaded email inbox, I found this gem:

Language
by J. Mark 

It's tragic
the way that everything falls away
when you name it:
those there, looming over this
here, their darkness,
their ability to catch the light
from that, there, hanging brightly.
It sounds so ridiculous to say it that way,
but there they all are:
the sun in the sky
over the small green earth, the peaks
that pull the horizon so close, so high,
glowing, their valleys blue-black
with shadow.
In our eyes they are the mountains
that we were promised: immutable.
But in word
they may as well be made of sugar.
They melt under their names
as under a hot running tap.
I could say nothing,
I should
give up singing these empty psalms,
hold your face tenderly between my hands
and turn it towards the view 

The idea that something as simple as describing something can be so complex in a multi-dimensional way.  It may just be deliriousness from sleep deprivation, but this poem reminded me that I know things that other people (or rather, other little people) do not know yet. For that, I should be mind blown. Yes, I am sure children will grow up and learn all about the sun and the stars - but will they know the things I know about schizophrenia, GERD, or animism? They might... but then again, they might not.

My clinical advisor recently reminded me of the quote, "Anything you learn becomes yours." That makes me feel pretty well off.

The Difficulty of Speaking with Children

I am very uncomfortable around children that are not related to me. I am always afraid I will overstep some social/personal boundary that will make parents and kids alike disapprove of me. I am all too aware of the phrase "stranger danger" and my consistent over-analytical perspective, however, I cannot help feeling tongue-tied whenever I am around a child.

Today we were able to speak with two seasoned pediatric nurses about their experiences in communicating with children. I was in awe of their demeanor and of their attitude toward their patients. I commented on my lack of ease around children and asked them whether it was possible to overcome my boundary fear. They responded warmly that in peds (short for pediatrics), boundaries cease to exist as one gets to know one's patient and patient's family. The nurses spoke about desensitizing the patient to their role through simple measures such as prolonged presence, fleeting touch, and speech pattern.

Part of treating a peds patient is acknowledging their needs based on their age group as well as their individual needs. For instance, if a school-aged peds patient is undergoing surgery one might try to explain the procedure based on the patient's interest in learning and give them some sort of responsibility used toward the burgeoning sense of competence. One might also encourage the patient to then explain the procedure to his or her family.

I do not want to make it seem as though I can now be the child whisperer (that is creepy and should probably not even be uttered facetiously), but by keeping those concepts and tips in the back of my mind, I hope I can now make positive contact with a child unrelated to me. (I have tried re-writing the previous sentence to make it sound less creepy, but let's be honest, a post talking about talking to children is already walking a fine line.)

Disturbed Sleep Pattern Related to Anxiety, Secondary to Nursing School

The title of this post is in the format of a Nursing Diagnosis. A nursing diagnosis is sort of like a medical diagnosis in that it identifies a particular aspect of a patient to treat, however, it is has more to do with the individual, family, or community experience/response to the medical diagnosis or life processes than the medical diagnosis itself. It is basically distinguishing things that nurses can do to affect a patient's treatment experience. I am going to take you through my nursing diagnosis step-by-step, partially because it is an educational experience for me and partially because it is a de-stressing activity.

Nursing school has so many side effects on nursing students. There are obvious ones like increased critical thinking and communication skills, decreased gag-reflex, and impaired writing skills. One major one for me is increased anxiety levels. Up until now, I have dealt with the anxiety-inducing events with ease, following the thought process that the event is going to happen anyway so I might as well prepare as best as I can for it while I can instead of stressing about it. Now, with a completed medication administration performance evaluation under my belt (as of this afternoon) and a major exam coming up tomorrow, my mindset is a bit less accepting. This afternoon, immediately before my performance evaluation, I felt the first symptoms of my anxiety. They diminished slightly after running at the gym, but resumed at a greater intensity after I returned to campus and studied with peers. My anxiety, as it is due to more than one factor of nursing school, is secondary to nursing school.

Although my heightened anxiety is of reasonable concern, it is not my major concern at the moment - my lack of sleep is. A "disturbed sleep pattern" is a nurse's way of saying I am not getting enough sleep for some reason. Despite having the right environment to sleep (a quiet, warm, dark room), an adequate amount of time to sleep, and providing myself with an almost excessive level of comfort (body pillow, three blankets, and a stuffed cat to cuddle - DO NOT JUDGE ME) I am consistently unable to fall asleep. Whenever I try to sleep, my brain will not "power down" and I continue thinking about the same things that are causing me stress, further amplifying my anxiety.

As I write, I realize that the explanation of my anxiety is not complete; I have not spoken to what anxiety is and how I experience anxiety (such as the physical response). I will not go into detail in this post about it as I do want to try to get some rest in preparation for my exam tomorrow, but I will emphasize that everyone experiences and expresses anxiety differently and that some forms of anxiety relief are not as effective for some as others.

Anyway, I hope you enjoyed my brief explanation of nursing diagnoses! If you have any questions, please feel free to leave them in the comments below.

Why I Like Working.

I sheepishly checked in with my "boss" this morning, a nursing professor, wondering if I had missed anything while I was sick. I had not received any emails nor had there been anything left for me in my box. She says to me, "Oh, no, I just didn't want to give you things to do while you were sick and getting through midterms." WHAT. A. SWEETHEART.

First of all, Linfield professors are the best. Secondly, people like her are why I like working.

I do not know if it is my sparkling personality (wink), but the people I have worked for have not been especially disagreeable. So far. (Knock on wood.) In fact, most of my bosses I have gotten on well with. My grandfather, Guello, used to tell me to make the most of whatever job I get and always strive to do the best job I can. The best-foot-forward attitude was emphasized by my Jesuit-Catholic education in which we were encouraged by the motto ad majoram dei gloriam, meaning, "for the greater glory of God."

As far as making the most of my current job, I am very pleased with how flexible it is with my busy schedule. Knowing that my professor will adjust my workload based on my schedule is a huge relief! Now that I am healthy again and past a couple midterms, I am back to a full workload including researching books and articles on various topics related to nursing.

Researching is fun! I am enjoying the challenge of finding the most relevant and contemporary studies. I actually read through them too - partially to see how best my professor may use them in her course and partially because I become curious about the study.

This job may prove the best yet - I have learned so much already from flipping through packets for class I copied! It may be nerdy, but I really like academic work.

SICK AND TIRED OF BEING SICK AND TIRED

I am finally getting over this awful cold though at this point, it does not sound like it. I can tell because my aches, sneezes, headaches, and lethargy are gone and have been replaced with renewed energy and determination to study for the upcoming exams.

We have been focusing on cardiovascular (heart, blood, and lungs) function, including tissue perfusion (spreading blood to the body) and related issues as well as medications. We had an interesting lecture by a substitute professor on pharmacodynamics, which is basically what drugs do in the body and how they do it. We do not fully study pharmacology until second semester, but it fit in with medication administration section.

Anyway, once I began studying I felt oddly at ease - comfortable, even. I do not know if it is mostly because my lifestyle very much resembles that of a student - sitting for long periods of time, rarely eating, drinking lots of caffeine - or if I enjoy studying that much. I mean, I do truly enjoy studying, but I wonder if my normal academically-oriented routine has become a sort of relationship.

There are often jokes shared about having a relationship with one's job, but I am starting to worry that I have a relationship with academia. Here are my top 10 reasons:

1. Most of my time is spent with it
2. I talk about it constantly with my friends
3. I can only take minimal breaks from it before feeling slightly guilty
4. I drink far too much with it (caffeine)
5. Sometimes I sleep with it
6. I can look/feel terrible and it does not mind
7. I spend quite a bit of money on it
8. It keeps me awake at night
9. My friends all know it and some even despise it
10. No matter how upset I get with it, I keep coming back

Disclaimer: This might be residual brain-scrambling from being sick.

It's Been a Rough Week.

This week has challenged me more mentally and physically than any other week of nursing school. Returning from my relaxing week back home, I literally hit the ground running - I was going to miss the streetcar and have to wait another twenty-something minutes for the next one. I had several meetings scheduled and events to arrange as well as homework and working out. Yet with all that I am doing, I could not outrun the cold that is going around campus. I am currently fighting, tooth-and-nail to get over it, but for some reason, I cannot shake it! I need not tell you how FRUSTRATING IT IS.

With all that is going on, I am more frustrated with the sources of my friends' worries. One of the biggest concerns has been clinical sites that lack concern for residents to the extent that the residents are not receiving adequate care. Another concern has been our research course, which does not seem to satisfactorily prepare nursing students for the papers assigned. The last major concern has been keeping track of all the assignments due for each class. Although it does not seem like a significant concern, the Linfield nursing curriculum is linked with four classes a semester that must be taken concurrently and sometimes course assignments seem to run into each other because they are similar in topic.

 It is unfortunate that some clinical sites do not provide adequate care for its residents, however, as nursing students we should take that upon ourselves to make a good example. This is what we are taught to do - to develop our critical thinking skills and make the healthcare community better as best as we can! It seems daunting for a first semester nursing student, but we are also adults with two years of education behind us.

As far as our research course goes, I applaud students' efforts to go above and beyond realistic expectations of educational standards of nurses. Not many nursing students will go into research, but they still feel the need to learn the material. The students are struggling to write a literature review. Not only have we had very little experience with APA formatting, we do not understand the structure of a literature review. It is one thing to have very little instruction but plenty of resources and it is another thing to have very little instructions and very little resources. Fortunately, students have bonded together and commiserated over the lack of collective knowledge.

The last concern my friends' had was over the seemingly haphazard scheduling of assignments. One piece of advice given to us at orientation was to write all the assignments and projects out in our planners so we would always have a complete reference. The unfortunate part of this, is that professors often rearrange schedules and accommodate to the learning styles of each class. This can form a jumble of problems for those nursing students who like to have clearly defined schedules.

I apologize for my rant, I just want people to realize that nursing students are humans too. My friends and I are all compassionate people that want to be the best nurses, and people, we can be. Nursing school is challenging me in ways I had not even imagined - and it is only the first semester! If all weeks are like this, I may need more support, but I refuse to give in and fall into the monotonous stereotype of a nurse. I am not going to college, putting in this much work, and drinking this much caffeine to end up like that.

Heurme- What? Mixing Anthropologic and Nursing Research

Today in my scholarship of nursing class we discussed at length the different types of qualitative research and some of their methods. It was exhaustive - and I am still get confused on what the difference between interpretive, heuristic, and heurmenuitics is! What was most annoying was my professor continually interjecting that we do not necessarily need to know further detail into the area we were studying or confused about unless we go into research.

Anyway, it reminded me of anthropological studies and how anthropologists conduct ethnographic research. It makes so much more sense to me from an anthropological perspective than from a nursing perspective! Nursing research makes me wonder whether I would have been better off as an anthropologist. I enjoy the idea of research, but the thought of obtaining a statistician simply because I cannot understand the reasoning behind the math irritates me. I would rather just do it myself instead of having someone tell me what to do.

The fact that (1) I could not grasp all of the concepts based on what my professor was lecturing and (2) my professor refused to answer questions that lead to a more in-depth explanation of the concepts that I did grasp initially discouraged me from wanting to pursue more information about nursing research. Then it occurred to me that my understanding of anthropological research might actually help me understand nursing research more than I thought. I have scheduled a meeting with my professor so I can express my confusion and interest in learning more about research. I am sure my professor will be confused by my persistence of the topics we were discussing in class today and will dissuade me from questioning the concepts we "do not necessarily need to know," but I hope he will dismiss my inquisitiveness as characteristic of a proper college student.

Who knows? Maybe in the future I will conduct research and implement both anthropological and nursing processes in my studies.

Oh My.

It is definitely getting busier and busier here in nursing school - we are past the introductory stage and into the learn-what-you-want-to stage. As stressed as I may feel, I know it is only because I am pushing myself to get things done ahead of time so I have time to catch up if I have questions or if I want to look up other related things. For instance, the other day in class we watched part of a YouTube video on congestive heart failure (CHF). Our professor showed it to us because of its relation to ineffective tissue perfusion (oxygen not getting to the body parts that need it), but I was really interested in it because I know someone who suffers from CHF so I "wasted" 10 minutes watching the rest of the video after class.

Even today at clinical I felt like I was bustling about the entire time - because I was! I had the opportunity to speak with the physical therapist, occupational therapist, and each of the nurses and CNAs. I also was able to help with perineal care, wound care, physical therapy, toileting, showering, feeding, and drug administration. I even had time to conduct a full health assessment (including vital signs; listening to bowel, lung, and heart sounds; and skin assessment) and work on paperwork on my resident for IEL!

I kept myself as busy as I could (1) because everything is still pretty new to me and (2) I wanted to have as many experiences as I could within the few weeks we have left. Needless to say, I am exhausted and it FEELS SO GOOD!

Nursing Diagnosis

Earlier this morning my friend and I were discussing other majors we would be if we could be more than one major. The self-imposed limit was four, so I chose five:

1. Athletic training
2. Anthropology
3. Psychology
4. Creative Writing
5. Microbiology

Sitting in the fading light of the afternoon helped me contemplate why I was not a double major. There were the obvious reasons (financial, temporal, etc.), but I kept returning to a thought I have had more and more frequently - there is too much to know. With whatever subject topic, there is literally too much to know. 

For instance, before I reflected on the previously mentioned conversation I was becoming increasingly overwhelmed with the amount of work I had to accomplish before the weekend. Added to the stress, I also felt the pressure of having to complete a major health requirement for clinical when I did not have the adequate level of health literacy to do so. (I'll talk about health literacy tomorrow. Point being, my anxiety level was high.) I could not imagine completing and being able to properly understand it all. There was too much to learn! 

My dilemma reminded me of a book I read over the summer called Too Big To Know which discussed the difficult topic of knowledge. It was a bit of a tough read conceptually, but it flowed well. I definitely recommend it for intellectual stimulation. Anyway, it talked about how knowledge has more depth now than ever before because of the increasing amount of knowledge available world-wide. It is actually rather mind-blowing. The book made it a point to reassure its readers that no matter how many books, articles, webpages, so on and so forth one reads, one will never be a know-it-all. As weird as it sounds, thinking about the book and all that it had to say calmed me and helped me focus on the tasks at hand. 

Oh the strange things I think about...

FIRST DAY OF CLINICALS!!

Basically all of my morning led up to clinical. Or at least that's how I felt. I was not nervous or anxious until I went searching for my ID badge. For some reason I had slipped it into the front pocket of my backpack and skipped over that pocket until about a minute before I was supposed to leave. My frantic search built up my anxiety for the evening ahead and arriving early definitely made it worse. Fortunately there was a chapel nearby so I took a moment to duck in and say a quick prayer.

Anyway, there was no need to worry. The nurses, CNAs, and staff were more than accommodating and many of the residents we encountered were encouraging and glad to have us there. Clinical proved itself to be an integral part in our education - for instance, I knew the steps to transfer a patient, but in actually doing it I realized sensitivity and forethought must accompany the steps. Thoughts such as adjusting pillows before seating a resident or scooting the resident back in the seat to make the resident more comfortable are simple things that one may not think about when learning from a textbook or practicing on a fully functional partner.

For fear of HIPAA and falling asleep at the keyboard (it has been a very long evening), I will cut myself off here. I hope to share more of my thoughts about and adventures in clinical in the future!